Active NPI
Shujaat Ali Khan, MD
- Pediatrics Physician
- Richmond, VA
National Provider Identifier
1306681374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0116039062
- Practice address
- 1000 E Broad St
Richmond, VA 23219-1930 - Phone
- (804) 828-9783
- NPI assigned
- Jul 1, 2024
- Last updated
- Jun 16, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0116039062 | VA | Primary |
Addresses
Primary practice location
1000 E Broad St
Richmond, VA 23219-1930
Mailing address
PO Box 980257
Richmond, VA 23298-0257
Phone (804) 828-9783
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240906003067 | VA | Order and Referring Only - Pediatric Medicine | 4587104351 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0116039062 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750032000000",
"number": "1306681374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 980257",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232980257",
"telephone_number": "804-828-9783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E BROAD ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232191930",
"telephone_number": "804-828-9783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "SHUJAAT ALI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-01",
"last_updated": "2025-06-16",
"certification_date": "2025-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0116039062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.